| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $83.51 | $83.51 | $83.51 |
Immunohisto/cyto chem 1st st
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $83.51 | $83.51 | $83.51 |